Trauma and its Effect on Refugees
In this section:
you will receive information about refugees
you get information about trauma and learn to recognize its symptoms
you will get information about the impact of trauma on well-being
INTRO
In this introductory video, we will highlight the prevalence of trauma among refugees and its significant impact on their lives. Understanding the psychological challenges many refugees face is crucial for anyone looking to provide effective support.
Refugee
A refugee is a person who has been granted international protection outside their home country. Refugees flee their homeland due to human rights violations, war, and unrest. They are forced to leave their country because they have a legitimate reason to fear persecution.
Currently, an estimated 100 million people are affected by refugee situations.
Anyone can become a refugee, regardless of age, gender, wealth, or life situation.
Being a refugee exposes individuals to many factors that threaten their psychological and physical well-being.
It often involves difficult, even traumatizing experiences and losses. In addition to losing their home region, familiar way of life, language, and culture, many refugees have lost loved ones, including family members, relatives, and friends.
More than half of immigrants with a refugee background have experienced traumatic events.
Some are left with trauma symptoms, and others may suffer from long-term illnesses. It is also common for refugees to experience symptoms of anxiety and depression, as well as challenges in coping with everyday life.
Trauma symptoms and reactions can manifest differently in each person.
Refugee and Trauma
An estimated 57–78% of immigrants with a refugee background have encountered traumatic events related to war, persecution, and discrimination. These experiences can occur in the country of origin, transit countries, or the new home country.
In crisis areas, there is often a shortage of basic necessities such as food, water, and shelter. Connections with family members and other loved ones may be severed, and important people may go missing. Basic routines are disrupted.
Many refugees also experience physical injuries and various diseases without access to proper healthcare.
In the country of origin, there may have been frightening and vulnerable experiences related to war, violence, or the threat of violence.
Being a refugee often involves significant changes, as well as feelings of sadness, uncertainty, and confusion, but also hope for a better future.
However, it is important to understand that not everyone who has experienced traumatic events becomes traumatized. An estimated 20–30% develop trauma-related stress disorders. At the same time, the human mind has the capacity for self-repair—difficult experiences can, at best, lead to post-traumatic growth.
In a New Country
Arriving in a new country may seem like a relief, but it often comes with significant changes and challenges in everyday life. Difficult past experiences can manifest as trauma symptoms and other mental and physical health issues. Integrating into a new environment and culture can also be stressful, leading to many adjustments.
Living standards and social status may change with refugee status, and the new home country may not meet the expectations you had, leading to significant disappointment.
In the past, family and community might have provided support and security, but in a new country, such a support network may be entirely absent.
Family members may adapt to the new culture and learn the language at different paces, which can alter family dynamics and lead to confusion, friction, and the need for readjustment.
Older children in the family might take on roles traditionally held by parents, creating additional stress.
Children often grow up between two cultures, which can be challenging and stressful.
However, settling in a new country can also be the beginning of a new life and an enriching experience. Over time, it may become possible to combine the best aspects of past and present experiences and cultures in a constructive way, both on an individual and community level.
Model of the Four R's
To support the structuring of trauma awareness, the so-called Model of the Four R's can be used. This model is based on the American SAMHSA organization's "The Four R's of Trauma-Informed Approach."
The model aims to:
Realize the widespread impact of trauma.
Recognize the symptoms and phenomena related to traumatization.
Respond by fully integrating knowledge about trauma into policies, procedures, and practices.
Resist retraumatization by using this knowledge to support individual and community recovery in everyday interactions and to prevent and combat retraumatization.
Trauma and Being Traumatized: Video
In this video, you will learn to recognize trauma symptoms, gain information about the impact of trauma on well-being, and discover methods to reduce these symptoms.
Watch the video here: Trauma and Being Traumatized (in Ukrainian, duration: 7:44 minutes).
What is Trauma and being Traumatized?
A traumatizing event is any threatening situation that a person experiences, which exceeds their tolerance and current means of coping.
A traumatic event can impact an individual, a family, a group, or an entire community.
Examples of a single traumatizing event include the sudden death of a relative or becoming a victim of violence.
A wider community can be affected by events such as a fire, the suicide of a loved one, a terrorist attack, a major accident, or a natural disaster.
Traumatizing events can also be recurring, such as bullying at school, domestic violence, sexual exploitation, or living under martial law.
Experiencing a life-threatening near-miss, witnessing a difficult event, or hearing about a traumatic event or death experienced by a loved one can also expose a person to traumatic stress.
Everyone’s experience and life story are unique, and people react to similar experiences in different ways—an event that is traumatic for one person may not be for another.
How Does Trauma Affect Well-being?
A traumatic experience can influence how a person thinks about their abilities and the continuity of life.
A traumatic event may also involve physical injury or disability.
Trauma symptoms are often accompanied by bodily reactions that cause physical symptoms and challenge a person’s ability to function.
Being traumatized is frequently associated with difficult emotions such as fear, anger, guilt, and shame. The range of emotions can become narrower, with feelings either becoming flat or varying intensely.
A powerful sense of helplessness may arise, along with the belief that one has no control over their circumstances.
The feeling of being an outsider or a foreigner can be heightened, especially if one has had to move to a very different culture or has been left alone.
Negative thoughts and beliefs about oneself, others, and the world may increase, such as "I'm contaminated," "No one understands," "You can't trust people," or "There's something wrong with me." The world may no longer seem as good and predictable as it once did. The perception of oneself may change, and a person can lose their sense of control, which can impact their ability to cope with everyday life.
Recognizing Trauma Symptoms
Trauma-related symptoms may include recurring memories of the event, reliving the experience, and trauma-induced nightmares.
A traumatized person often tries to avoid situations that remind them of the event and may be unable to recall certain key details.
These symptoms are often accompanied by psychological sensitization and hypervigilance, where attention is focused on detecting potential threats.
Changes in thinking, information processing, mood, and social interaction can also occur, and various physical symptoms are common as well.
Source: Turvaa, toivoa ja toimijuutta (hdl.fi)
Levander M., Luotonen K. & Vartio A.: Security, hope, and agency - information about the trauma of being a refugee for early childhood education and teaching professionals. Helsinki Deaconess Institute Foundation sr 2022
How Can Trauma Manifest in Practical Terms?
Problems with memory, concentration, and attention
Difficulty tolerating different emotional states
Insomnia, nightmares
Activation of defense reactions in safe or neutral situations
Avoidance behavior
Irritability, outbursts of anger
Fluctuations in alertness and related bodily reactions
Tension, bodily tension
Increased sensitivity to senses and emotions
Difficulty trusting other people
Nausea, stomach problems
Anxiety
Pains, aches
Various bodily symptoms
Feelings of insecurity and fear
Constant being on guard, startled
Challenges with self-esteem and self-confidence
Defense and Trauma Reactions
In a threatening situation, automatic defense reactions are activated, shifting us from our normal mode of information processing to a reactive mode focused on survival (fight, flight, freeze, collapse). In this state, all our resources are directed toward ensuring our survival.
Later, factors that remind us of the traumatic situation—such as various internal and external threat cues—can trigger these defense mechanisms even when there is no real threat. These reactions may be accompanied by a range of cognitive, psychological, and physical symptoms, which can be very frightening and confusing.
Trauma Flashbacks
In trauma flashbacks, memories related to the trauma resurface vividly and realistically. During these flashbacks, emotions associated with the event, such as fear and horror, are often activated.
Defensive reactions and related physical symptoms may also occur, which can be very unpleasant and frightening.
Frequent and uncontrollable flashbacks can lead to persistent fear, anxiety, and feelings of helplessness.
A central aspect of these experiences is the sensation of losing control over one’s mind and body, as powerful and distressing memories, images, feelings, and sensations are triggered unpredictably.
Triggers
A triggering factor, or "trigger," is anything that reminds a person of the traumatic event. This can include a place or situation similar to the event, or specific sounds and smells. Different body sensations, such as an accelerated heartbeat or shortness of breath, can activate the body's defense reactions even in seemingly neutral or safe situations. Often, individuals may not be aware of how to identify these triggers themselves.
A traumatized person may also avoid various emotional states for fear that they will trigger trauma memories and related reactions. Everyday activities, such as watching movies, playing games, or taking exams, can feel threatening and provoke strong defensive reactions. Even personal thoughts or falling asleep can feel dangerous, as anything may surface in mental images and dreams.
In some severely traumatized children and young people, trauma triggers can even be associated with positive experiences. Based on their previous experiences, they may have internalized the belief that positive experiences are not allowed or that something bad will follow. In these cases, it is crucial to pay individual attention to the child, gradually helping them recognize and become aware of their triggers and providing appropriate support measures.
Trauma Reactions
When it is not possible to fight or flee from a dangerous situation, a person may become paralyzed as a survival mechanism. This is a way to cope when physical escape is not an option. In this state, the body goes into a protective mode:
The body may become numb.
Mental and physical actions may slow down.
In extreme cases, a person may lose consciousness.
This response is intended to protect the body and mind from overwhelming pain and suffering.
Under intense threat, it is also possible to surrender to the situation, where a person gives up their agency and adapts in ways that may go against their will but are necessary for survival. In these cases, the body and mind adjust their actions to meet the demands of the situation, often by suppressing their own needs and values. This adaptation may conflict significantly with their personal values and beliefs.
Source: Turvaa, toivoa ja toimijuutta (hdl.fi)
Levander M., Luotonen K. & Vartio A.: Security, hope, and agency - information about the trauma of being a refugee for early childhood education and teaching professionals. Helsinki Deaconess Institute Foundation sr 2022
State of Alertness
When discussing symptoms caused by trauma, it is crucial to understand how trauma impacts both the body and mind. Trauma can lead to various mental and physical symptoms, as well as challenges in daily functioning.
The concept of "state of alertness" is often used to assess functional capacity. This refers to the level of mental and physical readiness, which typically varies throughout the day based on different situations. It is important for the state of alertness to remain within a tolerance zone to ensure smooth performance in everyday activities, emotional regulation, learning, social interactions, and rest and recovery.
Individuals who have experienced trauma may have an exaggerated or diminished (over- or under-tuned) state of alertness, with significant fluctuations. These uncontrollable variations can create challenges in functioning, affect learning, and complicate daily life.
Self-Assessment Tests
There are two tests available, followed by two important tasks. Scroll the page up and down as needed.
First Test
Second Test
Tasks
Provide some examples of how you could support the self-regulation skills of a traumatized person.
What questions could you use to map the current situation of a child, youth or adult and the occurrence and effects of possible trauma symptoms in everyday life?
1. Do you often have trouble falling asleep?
2 Do you often have nightmares?
3 Do you often suffer from headaches?
4 Do you often have other physical pains?
5 Do you get angry easily?
6 Do you often think about painful events from the past?
7 Are you often afraid or terrified?
8 Do you often forget things in your everyday life?
9 Have you lost interest in things?
10 Do you often have difficulty concentrating?